Individual
AMANDA LATONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
299 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1217
(631) 331-2204
Mailing address
47 BIRCHDALE DR, HOLBROOK, NY 11741-5903
(631) 624-4343
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
04/22/2024
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